Reimbursement for integrative health care suggests violation of non-discrimination law
A new study shows that the likelihood of health insurance reimbursement for some common clinical services differs significantly depending on whether they are provided by a complementary healthcare service provider or a primary care physician. A comparison of reimbursement rates for health services provided in a nonemergent outpatient setting is reported in the Journal of Alternative and Complementary Medicine, a peer-reviewed publication from Mary Ann Liebert, Inc., publishers. The article is available free on JACM website until June 22, 2017.
The article entitled "Insurance Reimbursement for Complementary Healthcare Services" is coauthored by James Whedon, DC, MS, Anupama Kizhakkeveettil, BAMS, MAOM, PhD, and Melissa Nagare-Kimura, MAOM, DC, LAC, CCSP, Southern California University of Health Sciences, Whittier, CA and Tor Tosteson, ScD, Geisel School of Medicine, Dartmouth College, Hanover, NH. The researchers found that compared with primary care physicians, the likelihood of reimbursement for any of the services included in the study was 69% lower for acupuncturists, 71% lower if provided by chiropractors, and 62% lower for doctors of naturopathic medicine. The authors suggest that these differences could affect access to and utilization of integrated medicine services.
"This report is particularly useful as a measure of the resistance of insurers to follow the law created with Section 2706 of the Affordable Care Act called 'Non-Discrimination in Health Care," says JACM Editor-in-Chief John Weeks, johnweeks-integrator.com, Seattle, WA. "The results suggest we have a significant enforcement issue."